The ad that Hims & Hers Health plans to air during the Super Bowl comes at you with rapid-fire visual overload—a giant jiggling belly, bare feet on scales, X-ray results, sugary sodas, a pie in the oven, a measuring tape snug around a waistline—all set to the frenetic hip-hop beat of Childish Gambino’s “This Is America.” A disembodied voice warns: “This system wasn’t built to help us. It was built to keep us sick and stuck.” The Super Bowl spot is a strikingly dark, politicized way of getting at the company’s latest initiative: selling weight-loss drugs to both women and men. The ad also marks a pivot for the telehealth company colloquially known as Hims, which rose to prominence just under a decade ago, slickly marketing hair-loss treatments and erectile-dysfunction drugs to men.

Since Hims’s founding in 2017, the company has been pointing toward a very particular future, one in which the word patient is interchangeable with customer. The Hims brand has primed people to view both their everyday health and the natural-aging processes as problems that can be tweaked and optimized—as if it were peddling operating-system updates for the human body. Now, as the national mood and the business environment shift, Hims’s message is undergoing its own reboot.

Catering to male anxiety can carry a company a long way: If you’re a man in your 30s, as I am, ads featuring Hims’s signature branding—a hip font on a bright background—have become inescapable across Instagram and Facebook. Hims sells all manner of pills, supplements, shampoos, sprays, and serums. Central to the Hims pitch is the fact that many people, especially younger men, avoid regularly going to the doctor; a recent Cleveland Clinic survey found that less than a third of Millennial and Gen Z men receive annual physicals. Hims markets the telehealth experience as a welcome alternative. After filling out an online intake form and communicating with a licensed provider from its partner group about hair loss, for example, you might be prescribed a Hims-branded chewable. One such offering, advertised at $35 or more a month, contains minoxidil, a medication that first hit the market in the 1980s as Rogaine, combined with finasteride, which most people know as Propecia, plus supplements.

On platforms such as Instagram, under the logic of targeted advertising, if you linger over an ad for one hair-growth supplement, similar ads will follow. In my daily tapping and scrolling through the app, Hims ads began to appear everywhere—and eventually got in my head. Some time last year, my self-interrogation started: How long has my hairline had that peak? Was my forehead always that … giant?

“The job of marketing is to influence behavior, and sometimes that means identifying problems that you may not know that you have, or underlying insecurities that may prevent you from losing social currency down the road,” Marcus Collins, a marketing professor at the University of Michigan, told me. A former advertising executive, Collins said that he, too, had been bombarded by Hims ads. He could see how Hims was trying to “elevate itself from being a shortcut that represents a hair-loss solution to being a solution for masculinity, to being an outlet for him, for what it means for manliness.”

In December, after my dermatologist examined my scalp during an annual skin screening, I sheepishly asked her about Hims. She rolled her eyes. When we moved to discussing treatment options, she also warned me that a potential side effect of using oral finasteride for hair growth is decreased libido, erectile dysfunction, or both.

After a few minutes of discussion, a topical solution seemed like a better bet than the pill. But there is nothing special about Hims itself. “If you want, I can just call in a minoxidil-finasteride solution to your pharmacy,” my doctor said. “It’ll be cheaper.” She saw me as her patient, not an e-commerce shopper. Still, the fact that I asked about Hims at all made me feel like the company’s pervasive marketing was working on me. One minute, I was reporting, checking out Hims-branded biotin gummies; the next minute, I was practically at the checkout, ordering some myself.

When I spoke with Mike Chi, Hims’s chief commercial officer, he leaned hard into words such as normalization and empower. I told him that the constant barrage of Hims ads had made me feel almost bullied into doing something about my hair. Chi disagreed with my characterization but acknowledged the high volume of the company’s ads. The goal of its campaigns, though, was “to create an emotional connection with a customer,” he said. “And to create that personal connection with a customer, we often have to have varied messaging to find the way in that connects with them.”

Even though Hims’s ubiquitous stuff-for-dudes marketing campaign has proved effective at tapping into male insecurity, treating masculine vulnerabilities with generic drugs has its commercial limits, and Hims faces growing competition in the space. A company called Ro (formerly Roman) has a model similar to Hims’s; Amazon has an online pharmacy and telehealth business. In the past several years, Hims has steadily expanded its business into a broader array of treatments for both men and women: antidepressants, anti-anxiety medication—and, as the Super Bowl spot indicates, weight-loss drugs that include a version of semaglutide, the active ingredient in Ozempic and Wegovy. Semaglutide is currently on the FDA drug-shortage list, a status that allows Hims and other companies to sell their own compounded versions. (The makers of Ozempic are urging the FDA to declare an end to the semaglutide shortage.) Going down the compounded glucagon-like peptide-1 (GLP-1) path is a bold gambit for Hims. The market for a monthly supply of hair-growth or erectile-dysfunction pills is limited to men in certain age brackets, but the perpetual quest for thinness and hotness transcends demographics.  

By some measures, Hims’s expansion has been successful. The company has accumulated more than 2 million regular customers and achieved a market cap of $9 billion. Last February, the company announced its first profitable quarter. Marketing accounted for 45 percent of Hims’s operating expenses during last year’s third quarter. Peter Fader, a marketing professor at the University of Pennsylvania’s Wharton School, told me that such a percentage is “absolutely high” when it comes to typical marketing costs in a successful operation. “And it’s not sustainable, either,” he added. “A lot of people do question [the company’s] long-term viability,” he said, but he also commended Hims for “rolling with the times.”

Although Hims’s stock has gone up 65 percent in the past month, investment experts seem split over the reason. Some appear confident in the value of the company’s prospects. Others, such as the CNBC host Jim Cramer, suspect that Hims’s surging stock price is the effect of a “short squeeze,” in which speculators’ bet on a future steep decline temporarily boosts the share price.

Even the Super Bowl ad carries pitfalls for Hims. On Friday, Senators Dick Durbin, a Democrat, and Roger Marshall, a Republican, sent a letter to acting FDA Commissioner Sara Brenner stating that Hims’s “Sick of the System” commercial “risks misleading patients by omitting any safety or side effect information” about an injectable weight-loss medication that appears in the ad. In response, a Hims spokesperson told me in an email, “We are complying with existing law and are looking forward to continuing working with Congress and the new Administration to fix the broken health system.” The person went on to imply that the company’s critics are defending the status quo. “The ad calls out industries that are part of a system that fails to prioritize the health of Americans,” the spokesperson said. “And now these industries are asking to shut the ad down.”

Hims is now doing business in a world where a concept such as “Make America healthy again” has rapidly migrated from a fringe political movement to the center of government. And although MAHA purists might shun pharmaceutical solutions, some potential customers might be sympathetic to Hims’s claim of being an ally against “the system.” The one-note, full-volume message in the Hims Super Bowl spot is that everything is rigged against you—keeping you overweight, making you unhealthy—and that you’re right to be mad about that.

The company could be betting that in a political moment when talk of needing more “masculine energy” is playing an outsize part, this vibe shift in its marketing strategy will help it reach an even bigger audience. Hims has done well selling its own recipes for masculine energy; now it figures it can do even better pushing remedies to help you take back control from the elites and make you feel great again. It’s audacious, possibly cynical, and probably very effective.

Editor’s Note: Is anything ailing, torturing, or nagging at you? Are you beset by existential worries? Every Tuesday, James Parker tackles readers’ questions. Tell him about your lifelong or in-the-moment problems at dearjames@theatlantic.com.

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Dear James,

I have a friend I used to be very close with—I was in her wedding party eight years ago—but life circumstances, life goals, and geographic distance have rendered us a lot less so. We don’t communicate much aside from reacting nicely to each other’s Instagram Stories, which don’t reveal a lot about a person. Recently, her posts, usually just happy photo dumps of her cat and vacations with her partner, have taken a turn; they’re full of odd quotes about being a bigger person, learning not to hate, purging one’s soul. She also posted an Instagram Story that made me think her cat was dead. But I follow her partner, too, and it seems that this person now lives in a separate city with the cat.

I feel called to check in, but all avenues seem awkward. Our last text exchange was just sharing links to news stories from months ago. Who am I to text, “Hey, saw on Instagram that you may be going through something”? I could send her a message on Instagram, but that seems insufficiently serious if she’s indeed going through a dark period as a result of what I presume to be a separation. If my presumption is wrong, then reaching out would be even more awkward. Any insight here?

Dear Reader,

This is why I’m not on Instagram.

You don’t get news about a person: You get shifts in curatorial policy. But it sounds as if your friend—unless she’s working on an elaborate cover story before embedding with a politically suspect performance-art troupe—is going through something. And as you’ve been conducting your own informal probe into her situation, you’ve been keeping in mind the old journalists’ maxim: Follow the cat. The cat has moved. The cat’s in a different city. The self-help quotes are proliferating. I smell brokenness.

The question is: Do you want to help her? Or are you just kind of fascinatedly tracking the downturn in her online vibes? (Another Instagram effect: It turns us into dissociated consumers of one another’s lives.)

If you do want to help her—and you were in her wedding party, which in my book gives you a stake, however remote, in this marriage—then I see nothing wrong with checking in via text, carrier pigeon, whatever. In fact, I would say: Definitely do it. It’s never too late, or too early, or too weird, to see if somebody’s okay. Encourage her, if you can, to give an account of herself that exceeds the pixelated Instagram version.

Rooting for the cat,

James

By submitting a letter, you are agreeing to let The Atlantic use it in part or in full, and we may edit it for length and/or clarity.

From inside the room, Robert F. Kennedy Jr.’s confirmation hearings felt at times more like an awards show than a job interview. While the health-secretary nominee testified, his fans in the audience hooted and hollered in support. Even a five-minute bathroom break was punctuated by a standing ovation from spectators and cheers of “We love you, Bobby!” There were some detractors as well—one protester was ushered out after screaming “He lies!” and interrupting the proceedings—but they were dramatically outnumbered by people wearing Make America Healthy Again T-shirts and Confirm RFK Jr. hats.

The MAHA faithful have plenty of reason to be excited. If confirmed, RFK Jr. would oversee an agency that manages nearly $2 trillion, with the authority to remake public health in his image. “He just represents the exact opposite of all these establishment agencies,” Brandon Matlack, a 34-year-old who worked on Kennedy’s presidential campaign, told me on Wednesday. We chatted as he waited in a line of more than 150 people that snaked down a flight of stairs—all of whom were hoping to get a seat for the hearing. Many of them were relegated to an overflow room.

Of course, Matlack and other RFK Jr. fans could be in for a letdown. Whether Kennedy will actually be confirmed as health secretary is still up in the air. There was less raucous cheering during the hearing on Thursday, as Kennedy faced tough questions from Republican Senator Bill Cassidy of Louisiana, whose vote could be decisive in determining whether Kennedy gets confirmed. But the realization of RFK Jr.’s vision for health care in America may not hinge on his confirmation. The MAHA movement has turned the issue of chronic disease into such a potent political talking point that people like Matlack are willing to trek from Pennsylvania to Washington, D.C., just to support Kennedy. Politicians across the country are hearing from self-proclaimed “MAHA moms” (and likely some dads too) urging them to enact reforms. They’re starting to listen.

Kennedy is best known as an anti-vaccine activist who spreads conspiracy theories. His more outlandish ideas are shared by some MAHA supporters, but the movement itself is primarily oriented around improving America’s diet and the health problems it causes us. Some of the ways MAHA wants to go about that, such as pressuring food companies to not use seed oils, are not exactly scientific; others do have some research behind them. Consider artificial food dyes, a major MAHA rallying cry. Multiple food dyes have been shown in animal studies to be carcinogenic. And although a candy-corn aficionado likely isn’t going to die from the product’s red dye, the additive is effectively banned in the European Union. (Kennedy claims that food dyes are driving down America’s life expectancy. There’s no evidence directly linking food dyes to declining human life expectancy, though one study did show that they cut short the life of fruit flies.)

Until recently, concerns over food additives, such as artificial dyes, were the domain of Democrats. In 2023, California became the first state in the nation to ban certain food additives: red dye 3, potassium bromate, brominated vegetable oil, and propylparaben. But now food-additive bans are being proposed in Donald Trump country, including West Virginia, Arkansas, and Kentucky. Some of the efforts, such as the Make Arkansas Healthy Again Act, are an explicit attempt to enact Kennedy’s agenda.

In other states, something a bit more Schoolhouse Rock is happening: The purported dangers of food ingredients are riling up Americans, who are then going to their lawmakers seeking change. Eric Brooks, a Republican state legislator in West Virginia, told me that he decided to copy California’s food-additive bill after being prodded by a constituent. “I said, Well, I don’t normally look out West, especially out to California, for policy ideas, to be honest with you,” he told me. “But once I had done the research and I saw the validity of the issue, I said, Okay.” Although his bill, which was first introduced in January 2024, did not move forward in the previous legislative session because, in his words, “there were bigger fish to fry,” Brooks hopes the national interest coming from the MAHA movement will motivate West Virginia legislators to take another look at the proposal.

Other red-state efforts to follow California’s lead have similarly not yet been passed into law, but the fact that the bills have been introduced at all signifies how motivated Republicans are on the topic. The MAHA moms may be enough to propel Kennedy to the job of health secretary. One Republican, Senator Jim Banks of Indiana, told Kennedy on Thursday that he plans to vote to confirm him because doing anything else “would be thumbing my nose at that movement.” Republicans are not only introducing bills to ban food additives; they’re also taking up Kennedy’s other MAHA priorities. Arkansas Governor Sarah Huckabee Sanders recently asked the federal government for permission to forbid food-stamp recipients in her state from using their benefits to buy junk food—a policy Kennedy has repeatedly called for.

Over the past two days, senators seemed shocked at just how loyal a following Kennedy has amassed. One pejoratively called him a prophet. MAHA believers I spoke with made clear that they want RFK Jr.—and only RFK Jr.—to lead this movement. Vani Hari, a MAHA influencer who goes by “Food Babe” on Instagram, told me that, if Kennedy fails to be confirmed, there “will be an uprising like you have never seen.”

But at this point, it seems that the movement could live on even without Kennedy. On Wednesday, the Heritage Foundation hosted a press gaggle with MAHA surrogates. Heritage, an intellectual home of the modern conservative movement, is now praising the banning of food dyes. This is the same pro-business think tank that a decade ago warned that should the FDA ban partially hydrogenated oils, trans fats that were contributing to heart attacks, the agency “would be taking away choices,” “disrespecting” Americans’ autonomy, and mounting “an attack on dietary decisions.”

Republicans have generally been a bulwark for the food industry against policies that could hurt its bottom line. Democrats and Republicans in Washington today seem more aligned on food issues than ever before. “When you have members on both sides of the aisle whose constituencies are now extremely interested in understanding fully what’s in their food products, it does shift the game a bit,” Brandon Lipps, a food lobbyist and a former USDA official under Trump, told me. After all, even Bernie Sanders, despite chastising Kennedy multiple times during this week’s confirmation hearings, professed his support for aspects of the MAHA movement. “I agree with you,” Sanders told Kennedy on Thursday, that America needs “a revolution in the nature of food.” During the same hearing, Cassidy said that he is struggling with Kennedy’s candidacy because, despite their deep disagreements on vaccine policy, on “ultra-processed foods, obesity, we are simpatico. We are completely aligned.”

Although MAHA has shown itself to be a unifying message, the real test will come down to the brass tacks of any political movement: passing actual legislation. How willing lawmakers—especially those with pro-business proclivities—will be to buck the status quo remains to be seen. Politicians have proved eager to speak out against ultra-processed foods; in that sense, MAHA is winning. But policy victories may still be a ways off.

Perhaps you’ve heard: Young people aren’t dating anymore. News media and social media are awash in commentary about the decline in youth romance. It’s visible in the corporate data, with dating-app engagement taking a hit. And it’s visible in the survey data, where the share of 12th graders who say they’ve dated has fallen from about 85 percent in the 1980s to less than 50 percent in the early 2020s, with the decline particularly steep in the past few years.

Naturally, young people’s habits are catnip to news commentators. But although I consider the story of declining youth romance important, I don’t find it particularly mysterious. In my essay on the anti-social century, I reported that young people have retreated from all manner of physical-world relationships, whether because of smartphones, over-parenting, or a combination of factors. Compared with previous generations of teens, they have fewer friends, spend significantly less time with the friends they do have, attend fewer parties, and spend much more time alone. Romantic relationships theoretically imply a certain physicality; so it’s easy to imagine that the collapse of physical-world socializing for young people would involve the decline of romance.

[From the February 2025 issue: The anti-social century]

Adults have a way of projecting their anxieties and realities onto their children. In the case of romance, the fixation on young people masks a deeper—and, to me, far more mysterious—phenomenon: What is happening to adult relationships?

American adults are significantly less likely to be married or to live with a partner than they used to be. The national marriage rate is hovering near its all-time low, while the share of women under 65 who aren’t living with a partner has grown steadily since the 1980s. The past decade seems to be the only period since at least the 1970s when women under 35 were more likely to live with their parents than with a spouse.

People’s lives are diverse, and so are their wants and desires and circumstances. It’s hard, and perhaps impossible, to identify a tiny number of factors that explain hundreds of millions of people’s decisions to couple up, split apart, or remain single. But according to Lyman Stone, a researcher at the Institute for Family Studies, the most important reason marriage and coupling are declining in the U.S. is actually quite straightforward: Many young men are falling behind economically.

A marriage or romantic partnership can be many things: friendship, love, sex, someone to gossip with, someone to remind you to take out the trash. But, practically speaking, Stone told me, marriage is also insurance. Women have historically relied on men to act as insurance policies—against the threat of violence, the risk of poverty. To some, this might sound like an old-fashioned, even reactionary, description of marriage, but its logic still applies. “Men’s odds of being in a relationship today are still highly correlated with their income,” Stone said. “Women do not typically invest in long-term relationships with men who have nothing to contribute economically.” In the past few decades, young and especially less educated men’s income has stagnated, even as women have charged into the workforce and seen their college-graduation rates soar. For single non-college-educated men, average inflation-adjusted earnings at age 45 have fallen by nearly 25 percent in the past half century, while for the country as a whole, average real earnings have more than doubled. As a result, “a lot of young men today just don’t look like what women have come to think of as ‘marriage material,’” he said.

In January, the Financial Times’ John Burn-Murdoch published an analysis of the “relationship recession” that lent strong support to Stone’s theory. Contrary to the idea that declining fertility in the U.S. is mostly about happily childless DINKs (dual-income, no-kid couples), “the drop in relationship formation is steepest among the poorest,” he observed. I asked Burn-Murdoch to share his analysis of Current Population Survey data so that I could take a closer look. What I found is that, in the past 40 years, coupling has declined more than twice as fast among Americans without a college degree, compared with college graduates. This represents a dramatic historic inversion. In 1980, Americans ages 25 to 34 without a bachelor’s degree were more likely than college graduates to get married; today, it’s flipped, and the education gap in coupling is widening every year. Marriage produces wealth by pooling two people’s income, but, conversely, wealth also produces marriage.

Contraception technology might also play a role. Before cheap birth control became widespread in the 1970s, sexual activity was generally yoked to commitment: It was a cultural norm for a man to marry a girl if he’d gotten her pregnant, and single parenthood was uncommon. But as the (married!) economists George Akerlof and Janet Yellen observed in a famous 1996 paper, contraception helped disentangle sex and marriage. Couples could sleep together without any implicit promise to stay together. Ultimately, Akerlof and Yellen posit, the availability of contraception, which gave women the tools to control the number and the timing of their kids, decimated the tradition of shotgun marriages, and therefore contributed to an increase in children born to low-income single parents.

The theory that the relationship recession is driven by young men falling behind seems to hold up in the U.S. But what about around the world? Rates of coupling are declining throughout Europe, as well. In England and Wales, the marriage rate for people under 30 has declined by more than 50 percent since 1990.

And it’s not just Europe. The gender researcher Alice Evans has shown that coupling is down just about everywhere. In Iran, annual marriages plummeted by 40 percent in 10 years. Some Islamic authorities blame Western values and social media for the shift. They might have a point. When women are exposed to more Western media, Evans argues, their life expectations expand. Fitted with TikTok and Instagram and other windows into Western culture, young women around the world can seek the independence of a career over the codependency (or, worse, the outright loss of freedom) that might come with marriage in their own country. Social media, a woman veterinarian in Tehran told the Financial Times, also glamorizes the single life “by showing how unmarried people lead carefree and successful lives … People keep comparing their partners to mostly fake idols on social platforms.”

[Read: The happiness trinity]

According to Evans, several trends are driving this global decline in coupling. Smartphones and social media may have narrowed many young people’s lives, pinning them to their couches and bedrooms. But they’ve also opened women’s minds to the possibility of professional and personal development. When men fail to support their dreams, relationships fail to flourish, and the sexes drift apart.

If I had to sum up this big messy story in a sentence, it would be this: Coupling is declining around the world, as women’s expectations rise and lower-income men’s fortunes fall; this combination is subverting the traditional role of straight marriage, in which men are seen as necessary for the economic insurance of their family.

So why does all this matter? Two of the more urgent sociological narratives of this moment are declining fertility and rising unhappiness. The relationship recession makes contact with both. First, marriage and fertility are tightly interconnected. Unsurprisingly, one of the strongest predictors of declining fertility around the world is declining coupling rates, as Burn-Murdoch has written. Second, marriage is strongly associated with happiness. According to General Social Survey data, Americans’ self-described life satisfaction has been decreasing for decades. In a 2023 analysis of the GSS data, the University of Chicago economist Sam Peltzman concluded that marriage was more correlated with this measure of happiness than any other variable he considered, including income. (As Stone would rush to point out here, marriage itself is correlated with income.)

The social crisis of our time is not just that Americans are more socially isolated than ever, but also that social isolation is rising alongside romantic isolation, as the economic and cultural trajectories of men and women move in opposite directions. And, perhaps most troubling, the Americans with the least financial wealth also seem to have the least “social wealth,” so to speak. It is the poor, who might especially need the support of friends and partners, who have the fewest close friends and the fewest long-term partners. Money might not buy happiness, but it can buy the things that buy happiness.